Dual-layer everted saphenous vein patch for pediatric femoral artery repair following ECMO decannulation

This operative technique describes a dual-layer everted saphenous vein patch for repairing large femoral arteriotomies after pediatric VA-ECMO decannulation. The method uses ipsilateral saphenous vein harvested through the same incision, everted to maximize endothelial contact and dual-layered for structural support, providing an accessible approach for pediatric surgeons without advanced vascular training to minimize complications and preserve lower extremity perfusion.